Category Archives: political correctness

An unusual connection of topics in the headline, I admit, but let me explain. We live in an era of political correctness gone mad to the point that I’ve been lambasted in the past for saying schizophrenic rather than a person with schizophrenia. I actually did a column years ago entitled something like sticks and stones….. where I discussed the silliness of terminology and the editor got letters of complaint.

Years ago, Dr Sally Satel wrote a book called PC, M.D.: How Political Correctness Is Corrupting Medicine I loved that book and wish I could remember who I loaned it to. I am a big fan of hers for many reasons and one is her sensible attitude to treatment and committal for those with serious mental illness.

Political Correctness just turned up in Ontario when a political cartoonist published a bang on cartoon of Ontario cabinet minister Lisa MacLeod. The cartoonist in this case was Michael De Addar whose recent Trump cartoon went viral and he was fired from his freelance gig. If you visit the link above, you will see the Trump cartoon that got him fired.

In that link, De Adder describes the role of a political cartoonist and the top role is sarcasm or, as the Brits say, to take the piss out of people. That is what he does and political cartoonists have always done that well.

After being fired, he was picked up by the Toronto Star which has a long history of brilliant political cartoonists. His first cartoon for them got him in trouble again for making fun of the mentally ill but called mental health issues because to call someone mentally ill is not politically correct.

Some background. Most people are familiar with the late Rob Ford who became mayor of Toronto as his antics with drugs made headlines around the world. His big brother Doug desperately wanted to follow him as mayor but he was trounced. He managed to become leader of the Ontario Conservative Party when they turfed their leader and entered the election in 2018 when the incumbents had been in office for so long that their approval rating was rock bottom.

Doug won with no platform and immediately began cutting services for everyone. His minister, Lisa MacLeod, tried to reform the treatment programs for the autistic (persons with autism) and their families and was greeted with jeers, disdain, and numerous protests. The governments’ popularity fell to unprecedented levels within a year (60% surveyed reported July 15 that they felt the government was corrupt) so that in desperation, Doug demoted most of his cabinet and had them replaced.

The lady who messed up the autism file is now the Minister of Tourism, Culture and Sport and she went to see the Rolling Stones at their recent concert in Ontario. While there, she spotted Eugene Melnyk, the owner of the Ottawa Senators hockey team (and Ms MacLeod comes from Ottawa). She went up to him and said:

“Do you know who I am?” and, “I am your minister and you’re a f—ing piece of s—t and you’re a f—ing loser’.”

She later apologized on twitter but De Adar’s cartoon showed her in a straight jacket being led away by two men in white coats.

None of this upsets me as someone with mental illness in the family and who has written and advocated for years for better treatment. It did upset many who felt that the cartoon promoted stigma for the mentally ill and made it more difficult for people to get help.

Camille Quenneville, CEO of the Canadian Mental Health Association, stated so well in a letter to the editor published in the Star in protest of the de Adder cartoon:

“The cartoon depicting the Hon. Lisa MacLeod in a straitjacket is heartbreaking and demoralizing for all of those suffering, and the people supporting them. I cannot imagine the Star printing a cartoon maligning a cancer patient.”

The Star’s public editor in the link above, agreed. It seems that some people knew that Ms MacLeod had once mentioned that she had problems with depression and anxiety and so this was an unfair attack on her and on the mentally ill.

What is unfair is the lack of treatment services for those with serious mental illness. That upsets me. Not an attack on a politician who was caught trying to throw her weight around and invoke her self believed power over others. The fact that she has had an issue with depression in the past is no excuse to cut her some slack.

And suggesting she be carted off in a straight jacket is simply the sarcasm of a political cartoonist popping the balloon of a self important politico.

Sarcasm from the Oxford English Dictionary is “The use of irony to mock or convey contempt.” The target of that contempt was a politician and not those with mental illness.

If people want to become incensed about our attitudes to mental illness, they should start to demand to know why so many are untreated, homeless and/or in jail. That is the obscenity!

At the other end of the spectrum of care (from Marvin’s blog on Monday) we seem to be equally devoid of common sense, and strangely enamoured of something we call “privacy rights” for teenagers. This at a time when teens themselves are withholding very little on their snapchat and facebook posts. This at a time when a contemporaneous news report referred to a study finding teens who SEXT one another at higher risk of anxiety, depression and suicide. This at a time when we have a better understanding of the delights and limitations of the teenage mind/brain than we ever had before. This at a time when the parents themselves are not Victorian but grew up in the 60’s, 70’s, and 80’s.

In this article a doctor is quoted as saying that often “teens are uncomfortable talking about birth control and abortion” in front of their parents. Of course they are. But that discomfort lasts mere seconds, like getting a vaccination, whereas the consequences of unprotected sex and illicit drug use can last a life time, and by life time I mean the life time of the teenager and his or her parents and sibs.

And by and large they want their parents to know what they are doing (unconsciously at least) because then their parents may be able to protect them. And I myself find it easier to get the truth out of a teenager when a parent is in the room. Alone he or she can easily lead me astray, can sell me on his good school attendance, his abstinence from drugs, his many friends he hangs with. With a parent in the room when the question of drugs is asked, the boy glances at his mother, she raises her eyebrows, and then he sheepishly tells the truth. And then the mother may tell me that he hasn’t been to school, and he hasn’t seen his good friends in two months. And now we can talk about what is actually happening, and not about the very limited (and instinctively self-protecting) world view of this teenager.

Note that from the teenage perspective words and phrases that denote time spans, frequency, and quantity are used randomly. (forever, never, all the time, every day, like once a week maybe, pretty much, mostly, basically, sure, I guess, whatever………)

If the teen suffers from an actual mental illness it is imperative the parent(s) be involved, for the understanding, acceptance of treatment, and the outcome will be much better.

If the problem is addiction or being on the pathway to addiction, parents are the strongest tool in the treatment tool box; I would go further, for alcoholism and addiction in adolescence, parents are the only effective tool in our tool box. Perhaps not parents alone but parents working with the counsellors and doctors and teachers to bring about a change in behaviour of the adolescent who lives in their house and eats from their refrigerator and pilfers from momma’s purse.

I always thought that the only area of medicine that applied absurd political correctness concepts to the detriment of those needing help was in the treatment of those with serious mental health illnesses. I was wrong. And note that I am not being politically correct when I say mental health illnesses rather than mental health issues and problems.

Readers of this blog probably need no introduction to one of the main deterrents to treatment for people who are ill and do not know they are ill. In most jurisdictions in North America, it is hard to hospitalize someone against their will when they are very ill because we bend over backwards to defend their rights to not be hospitalized. Better to let them live on the street or be in jail than to force them into a medical institution.

Sadly, Ontario goes even further by allowing someone who is hospitalized involuntarily because they pose a danger to themselves or others to then refuse the treatment that will enable them to get well. Consequently, there are people in hospitals for years left sick and untreated because we respect their right to not take medication.

It turns out that we apply the same stupid rules to those with Alzheimer’s. In Ontario, at least. A number of years ago, I arranged for my mother to go into a nursing home because she had dementia. She had been assessed at a geriatric facility in Toronto described as “a global leader in geriatric residential living, healthcare, research, innovation and education, with a special focus on brain health and aging”. She did not have Alzheimer’s but dementia which was visible on MRI studies of her brain.

As a result, I had no difficulty finding a suitable nursing home for her. She was not happy going into it but she did become a long term resident for probably well over 20 years, enjoyed her stay and was well cared for. It was probably the mid 1980s when she went there.

Fast forward to today and I am the power of attorney for someone with Alzheimer’s as his family is spread around the globe with no one locally to look after his needs. The disease has robbed him of his ability to have any insight into his diagnosis much like anasognosia for those with serious mental illness. His Alzheimer’s was diagnosed by a leading Toronto hospital affiliated with the Faculty of Medicine at the University of Toronto. He has been assessed countless times with the standard mini mental status exam and it is obvious talking to him that he has dementia.

But here is the thing. He is not capable and while he lived alone, he had to have substantial support at home and he was going to a day program for those with dementia. When a spot opened for him at a very good home for dementia patients, we arranged for him to be admitted. He refused, of course, and as his power of attorney, I was worried about moving him and selling his condo. I spoke to the social worker at the geriatric unit who told me that his test scores were bad and that if I listened to him and did not have him placed, I would be remiss in my duties.

Two members of his family flew to Toronto and had him placed there. He got used to it and is happy and safe.

The problem for the future is that the home is not capable of providing intensive nursing care so their residents will eventually need to be moved to a nursing home. With the aging population, there is a shortage of these beds and a long waiting list. Beds in acute care hospitals and dementia homes are held by people who need nursing home but are occupying beds until a place opens up in a more appropriate setting, As this individual is starting to deteriorate, I tried to fill out an application for a nursing home to prepare for his future needs.

Turns out that is now complicated. Ontario has a bureaucracy called the Community Care Access Centres which co-ordinates home care and placements. It is a huge bureaucracy which no longer exists by name as it was merged with another large bureaucracy but the functions are there. My charge has a case worker who authorized some minimal home care for him and did periodic assessments. I called her to get an application and left a voice mail.

Next day, I received a call that they cannot send me an application because his file is inactive and I have to start intake all over again. It will only take a few minutes and I was transferred to someone else who took down the information they already have. I was told I would get a call to arrange a new assessment. Another one.

I then got a call from someone who I could not understand on my my voice mail but I did get the phone number and extension. I fully expected the person who called to answer but no, I got someone else. She had no idea who called me or why but found the name of the case manager who would call me. When I did get to talk to the case manager, I was told that she must do an assessment because his last assessment was a year ago and his status might have changed.

Of course it has, I told her. He has Alzheimer’s which does not go away and is progressive. In the past year, he has gone to living alone with support to needing a home. He now has a small GPS device in case he gets separated from his caregiver while out which did happen. And he will continue to deteriorate and will eventually need a nursing home. I wanted to put in the application because it can take 2-3 years to find a good one. Regardless, she said, I have to test his competence and tell him we are applying for a nursing home.

But if you tell him about a nursing home, it will set him off and he may not recover from that. He denies he has the disease and he thinks he is employed at the day program he goes to. His competency can be assessed without the need to tell him. I have to tell him she said. It is only fair and I cannot hide it from him.

As a result, I told her no. I will wait until he deteriorates to the point where his placement is an emergency and he will remain in a bed that someone else could use until the system finds him a place that is more appropriate. This is a problem that is happening throughout Ontario. Patients blocking beds in acute care hospitals they do not need because they need a nursing home and can’t find one. And the blame for all this goes to the bureaucrats.

Since this encounter, the Canadian government announced a $50 million dementia strategy that includes prevention and anti-stigma. Sound familiar to the mental illness advocates? How does one prevent Alzheimer’s and other forms of dementia when the causes are not known? What does stigma have to do with anything. As an aside, I wrote a book on Alzheimer’s in the late 1980’s and nothing has changed from then. Same with our treatment of schizophrenia. My 10 year old book on Schizophrenia is pretty much as relevant today as it was in 2008 when it came out.

Like many others (according to Google) I had to check the lyrics to see what the fuss was about.

The male lyrics in this duet are a little 1950’s pushy. It is easy to see Frank Sinatra or Dean Martin in the role.

But there is nothing in the female lyrics that indicate she does not want to stay. Rather she wrestles with what her father, her mother, her brother, the neighbour, and even her stern maiden aunt will say. She is conflicted. She wants to stay but what will people think? He, on the other hand, seems to have no qualms, no conflicts. But then, presumably, he is single; it is his apartment she is visiting; he is not worried about what his mother, father, brother, the neighbours, or a maiden aunt might say. This male may even boast about his conquest with his buddies the next day. But there is no indication from the lyrics that he holds some sort of economic or employment power over her.

So, in some ways, this song is a nice bit of sociological observation of the times. A casual sexual encounter puts the woman at far more social risk than it does the man.

And she wrestles with this. She is portrayed as an adult woman tying to thread her way between her needs and wants and societal values of the time.

To ban this song is not only silly it is very regressive. Banning the song infantilises women. It does imply (not the song, the ban) that adult women are so fragile that they should never be put in a position to decide on their own to stay or not to stay. Such a ban, trying to avoid one denigrating stereotype, promotes an equally denigrating stereotype.